MEDICARE: LHCG CIV, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency
2	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265947535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LHCG CIV, LLC

Provider Business Mailing Address
First Line	:	PO BOX 51266
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70505-1266
Country	:	US
Telephone Number	:	337-233-1307
Fax Number	:	337-443-4154

Provider Business Practice Location Address
First Line	:	2904 JENNY LIND RD STE B
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72901-6735
Country	:	US
Telephone Number	:	479-226-8503
Fax Number	:	479-452-2150

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSHUA L PROFFITT
Credential	:
Telephone Number	:	337-233-1307

Provider Enumeration Date	:	12/08/2017
Last Update Date	:	05/04/2026

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